KMT2E 基因相关神经发育障碍患儿的临床特征及基因型-表型相关性:两例新病例报告及文献复习
Clinical Characteristics and Genotype-Phenotype Correlation in Children with KMT2E Gene-Related Neurodevelopmental Disorders: Report of Two New Cases and Review of Published Literature.
机构信息
Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
出版信息
Neuropediatrics. 2021 Apr;52(2):98-104. doi: 10.1055/s-0040-1715629. Epub 2020 Oct 27.
BACKGROUND
In recent years, many new candidate genes are being identified as putative pathogenic factors in children with developmental delay and autism. Recently, heterozygous mutations in the gene have been identified as a cause of a unique neurodevelopmental disorder with variable combination of global developmental delay or isolated speech delay, intellectual disability, autistic features, and seizures.
METHODS
Here, we present two new cases of mutation-associated neurodevelopmental disorder in a 4-year-old girl and 5-year-old boy. We also performed a pooled review of the previously published cases of -related neurodevelopmental disorder. Articles were identified through search engines using appropriate search terms.
RESULTS
Along with the presented 2 cases, 40 cases were analyzed. Out of them, 30, 6, and 4 children had protein-truncating mutations, missense mutations, and copy number variants, respectively. The common features were global developmental delay (97%) followed by macrocephaly (35%), seizures (30%), and autism (25%). Children with missense variants had severe phenotype, with microcephaly, profound developmental delay, and increased frequency of seizures. Neuroimaging revealed nonspecific changes, including cerebral white matter signal abnormalities.
CONCLUSION
-related neurodevelopmental disorder remains one of the clinical differentials in children with global developmental delay and/or autistic features/seizure. With the reporting of more cases in the future, the already heterogeneous clinical spectrum of this disease is likely to be widened.
背景
近年来,许多新的候选基因被鉴定为儿童发育迟缓与自闭症的潜在致病因素。最近,基因的杂合突变被鉴定为一种独特的神经发育障碍的原因,其具有多种组合的表现,包括全面发育迟缓或孤立性语言迟缓、智力障碍、自闭症特征和癫痫。
方法
在这里,我们介绍了 2 例新的与突变相关的神经发育障碍病例,分别为一名 4 岁女孩和一名 5 岁男孩。我们还对以前发表的与相关的神经发育障碍病例进行了汇总回顾。通过搜索引擎使用适当的搜索词来识别文章。
结果
连同所呈现的 2 个病例,共分析了 40 个病例。其中,30 个、6 个和 4 个儿童分别具有蛋白截断突变、错义突变和拷贝数变异。共同的特征是全面发育迟缓(97%),其次是大头畸形(35%)、癫痫(30%)和自闭症(25%)。具有错义变异的儿童表现出严重的表型,包括小头畸形、严重的发育迟缓以及癫痫发作频率增加。神经影像学显示非特异性变化,包括脑白质信号异常。
结论
与相关的神经发育障碍仍然是全面发育迟缓及/或自闭症特征/癫痫儿童的临床鉴别诊断之一。随着未来更多病例的报告,该疾病的已有异质性临床谱可能会扩大。